1/57. Catamenial pneumothorax--3 case reports and view of literature.INTRODUCTION: The unusual correlation between chronic recurring spontaneous pneumothorax and the menstrual cycle, was first presented by Maurer in 1958. In our clinic we had 3 cases in 5 years. The anamnesis shows that this syndrome is unknown to many of our colleagues. Not mentioned in several standard textbooks, warrants our attention. methods: In 5 years we had 3 cases of C.P., all of them had already on admission, at least one recurrence; all of them had right sided thoracic pain and dyspnoea. They undergone video-assisted thoracoscopy, with histological examination of diaphragm specimen. Gynaecological consultations was followed by hormonal therapy and follow up. RESULTS: In all 3 cases we found no signs of lung defects or bullae, instead, we identified diaphragm defects of different extension, even a liver prolapse in one of the cases. endometriosis extra genitalis could be diagnosed in only one case which undergone a hysterectomy 8 years before. CONCLUSION: A spontaneous pneumothorax which recurs in correlation with menses has a pathogenesis which concern only women, that is why is referred to as catamenial. Our experience supports the hypothesis, that air in the pleural cavity originates from the peritoneal one, arriving here via uterus and tuba. Beside the symptomatic therapy ther is an etiological one, by inhibition the menstrual cycle. Thoracosurgical intervention could help preventing recurrence, and contributes in clarifying the pathogenesis.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
2/57. Tension pneumoperitoneum associated with a pleural-peritoneal shunt.The differential diagnosis of pneumoperitoneum is broad. We report a case of tension pneumoperitoneum in a patient on mechanical ventilation with initially unrecognized pneumothorax who had an indwelling pleural-peritoneal shunt. The patient developed ventilatory and hemodynamic collapse as air was diverted from the pleural space into the peritoneal cavity. Subsequent abdominal exploration revealed the source of the intra-abdominal air. Placement of a chest thoracostomy tube and removal of the pleural-peritoneal catheter resulted in significant clinical improvement. We suggest that it is important to recognize that pleural-peritoneal catheters may cause tension pneumoperitoneum without obvious concurrent pneumothorax.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
3/57. Congenital diaphragmatic hernia misdiagnosed as pneumothorax in a newborn.Congenital diaphragmatic hernia (CDH) is usually left sided and has a large defect allowing abdominal viscera herniated into thoracic cavity. The chest films usually show air-filled stomach and/or loops of bowel in the ipsilateral hemithorax with mediastinal shift. We report a newborn with CDH, presenting as hyperlucent hemithorax, right-shifted mediastinum, apparently normal pattern of abdominal bowel gas, with the tip of nasogastric tube below the left hemidiaphragm on the radiograph. It was initially misdiagnosed as pneumothorax, and the acute respiratory distress was temporarily relieved by needle aspiration. Hyperlucent hemithorax due to intrathoracic gastric dilatation alone is an unusual presentation of CDH in neonatal period. Absence of stomach bubble in the left upper quadrant of the abdomen, in both radiography and abdominal sonography, is an important clue to make diagnosis of CDH in this misleading condition.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
4/57. Traumatic herniation of the heart into the right hemithorax.Pericardial rupture after blunt chest trauma is described in the literature. This case report summarises our experience with a 22-year old male patient who suffered blunt chest trauma during a motor vehicle accident. On admission no serious injuries could be detected, but 3 hours later, displacement of the heart to the right hemithorax combined with sudden cardiac failure appeared. Emergency thoracotomy revealed a right-sided rupture of the pericardium with complete herniation of the heart into the right pleural cavity and consequent strangulation by the margins of the pericardial defect.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
5/57. Tension pneumothorax as a complication of video-assisted thorascopic surgery for anterior correction of idiopathic scoliosis in an adolescent female.STUDY DESIGN: This case report illustrates the occurrence of intraoperative tension pneumothorax, a previously unreported complication occurring during anterior instrumentation for correction of scoliosis by video-assisted surgery. OBJECTIVES: To demonstrate a consequence of overadvancement of a Steinmann pin (guide wire). SUMMARY OF BACKGROUND DATA: Although intraoperative tension pneumothorax is admitted to be a theoretical complication of video-assisted surgery for anterior correction of idiopathic scoliosis, there has yet to be a case reported in the literature. This report presents the first case of this complication. methods: A 13-year-old girl who had right thoracic scoliosis with a curve measuring 54 degrees underwent video-assisted surgery discectomy and anterior spinal fusion with instrumentation of T5 through T11. Single-lung ventilation had been achieved with a double-lumen tube and the right lung was deflated. After approximately 4.5 hours of complication-free surgery, intraoperative fluoroscopy showed an approximately 2-cm overadvancement of a guide wire into the opposite hemithorax. Approximately 5 minutes after the overadvancement was corrected, the patient experienced a gradual increase in heart rate and a corresponding gradual decrease in oxygen saturation and both systolic and diastolic blood pressures. Approximately 35 minutes later, it was determined that the patient had sustained a tension pneumothorax of the left hemithorax. RESULTS: The patient underwent urgent partial reinflation of the right lung and a tube thoracostomy of the left thoracic cavity. vital signs quickly returned to stable levels, and the left lung easily reinflated with the chest tube suction. The patient remained stable after the procedure was resumed (by right lung deflation). The remainder of the surgery and the postoperative course were uneventful. CONCLUSIONS: Although video-assisted surgery continues to gain popularity in the management of spinal deformities, the surgical team must be certain to pay meticulous attention to detail throughout the procedure. The early detection and treatment of complications can be life-preserving.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
6/57. Cervical emphysema, pneumomediastinum, and pneumothorax following self-induced oral injury: report of four cases and review of the literature.Spontaneous rupture of the pulmonary alveoli after a sudden increase in intra-alveolar pressure is a common cause of pneumomediastinum, which is usually seen in healthy young men. Other common causes are traumatic and iatrogenic rupture of the airway and esophagus; however, pneumomediastinum following cervicofacial emphysema is much rarer and is occasionally found after dental surgical procedures, head and neck surgery, or accidental trauma. We present four cases of subcutaneous emphysema and pneumomediastinum with two secondary pneumothoraces after self-induced punctures in the oral cavity. They constitute an uncommon clinical entity that, to our knowledge, has not been reported in the literature. Its radiologic appearance, clinical presentation, and diagnosis are described.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
7/57. pneumothorax after nasoenteral feeding tube placement.Nasoenteral tubes are placed routinely for feeding in patients in intensive care units and medical-surgical floor settings. Safe placement in the stomach/postpyloric location is performed by a wide array of medical personnel. We report a patient with placement of a nasoenteral tube into the pleural cavity.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
8/57. Haemodynamic compromise during thoracoscopic/laparoscopic oesophagectomy.Minimally invasive oesophagectomy is a relatively new procedure that is performed by means of thoracoscopy and laparoscopy. One stage of the procedure involves creation of a peritoneo-pleural communication in the presence of a pneumoperitoneum. In the case presented, severe hypotension occurred at this point. We believe this was caused by the escape of carbon dioxide from the peritoneal cavity into the right hemithorax, resulting in tension pneumothorax and cardiac tamponade. We believe this to be a predictable complication of this procedure but one that if expected, recognised and correctly managed, should not result in adverse outcomes.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
9/57. Anesthetic implications of thoracic endometriosis.endometriosis occurs in 5% to 10% of women of childbearing age and involves the proliferation of endometrial tissue outside the uterine cavity. Thoracic endometriosis is the most frequent extrapelvic manifestation of endometriosis, numbering some 100 reported cases. It may include spontaneous pneumothorax, hemoptysis, chest pain, bronchiectasis, pneumomediastinum, or mediastinal bleeding. Because the tissue is hormonally responsive, all of these manifestations are related to the menstrual cycle (catamenial) and are likeliest to occur during menses. We report the successful anesthetic management of a patient with thoracic endometriosis and recurring catamenial pneumothorax who presented for elective pelvic surgery.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
10/57. pneumothorax manifesting primary lung cancer.pneumothorax is a rare lung cancer manifestation. We report 2 patients in which pneumothorax occurred as a first manifestation of lung cancer. Postoperative lung tissue examination after pneumothorax showed lung cancer by chance. One patient had dissemination suspected due to ruptured bulla with adenocarcinoma. Both immediately underwent additional lobectomy with mediastinal lymphadenectomy after lung cancer was diagnosed, but we detected lung cancer recurrence in the bottom of the pleural cavity on the same side some 11 months after radical surgery in the patient suspected of dissemination. We could resect it completely, followed by adjuvant radiotherapy. The possibility of lung cancer should thus be considered in pneumothorax patients, even if middle-aged.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
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